How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,479.11 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,479.11 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $4,168.69 | Professional | None | $213.80 | $213.80 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,187.76 Typical High $7,079.46 | Facility | None | $758.58 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $204.17 | Professional | None | $107.15 | $125.89 | $204.17 |
CareSource Setting Professional Modifier None Typical Low $316.23 Median $4,073.80 Typical High $7,079.46 | Professional | None | $316.23 | $4,073.80 | $7,079.46 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,584.89 Typical High $2,691.53 | Facility | None | $549.54 | $1,584.89 | $2,691.53 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $1,584.89 Typical High $2,691.53 | Facility | None | $549.54 | $1,584.89 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $60.26 | Professional | None | $50.12 | $50.12 | $60.26 |
SummaCare Setting Facility Modifier None Typical Low $758.58 Median $794.33 Typical High $912.01 | Facility | None | $758.58 | $794.33 | $912.01 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $8,317.64 | Facility | None | $851.14 | $2,630.27 | $8,317.64 |
United Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $588.84 | Professional | None | $190.55 | $295.12 | $588.84 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $107.15 Typical High $158.49 | Professional | 52 · Reduced service | $107.15 | $107.15 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $63.10 | Professional | 53 · Discontinued | $42.66 | $42.66 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $234.42 | Professional | 54 · Surgery only | $158.49 | $158.49 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $47.86 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $31.62 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $31.62 |
Where Ohio sits
The same service costs 19.5 times more in Texas than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Ohio· 45th of 51
$214
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.